Age-related hearing loss (presbycusis) is the loss of hearing that gradually occurs in most of us as we grow older. It is one of the most common conditions affecting older and elderly adults.
Approximately one in three people in the United States between the ages of 65 and 74 has hearing loss, and nearly half of those older than 75 have difficulty hearing. Having trouble hearing can make it hard to understand and follow a doctor’s advice, respond to warnings, and hear phones, doorbells, and smoke alarms. Hearing loss can also make it hard to enjoy talking with family and friends, leading to feelings of isolation.
Age-related hearing loss most often occurs in both ears, affecting them equally. Because the loss is gradual, if you have age-related hearing loss you may not realize that you’ve lost some of your ability to hear.
There are many causes of age-related hearing loss. Most commonly, it arises from changes in the inner ear as we age, but it can also result from changes in the middle ear, or from complex changes along the nerve pathways from the ear to the brain. Certain medical conditions and medications may also play a role.
Why do we lose our hearing as we get older?
Many factors can contribute to hearing loss as you get older. It can be difficult to distinguish age-related hearing loss from hearing loss that can occur for other reasons, such as long-term exposure to noise.
Noise-induced hearing loss is caused by long-term exposure to sounds that are either too loud or last too long. This kind of noise exposure can damage the sensory hair cells in your ear that allow you to hear. Once these hair cells are damaged, they do not grow back and your ability to hear is diminished.
Conditions that are more common in older people, such as high blood pressure or diabetes, can contribute to hearing loss. Medications that are toxic to the sensory cells in your ears (for example, some chemotherapy drugs) can also cause hearing loss.
Rarely, age-related hearing loss can be caused by abnormalities of the outer ear or middle ear. Such abnormalities may include reduced function of the tympanic membrane (the eardrum) or reduced function of the three tiny bones in the middle ear that carry sound waves from the tympanic membrane to the inner ear.
Most older people who experience hearing loss have a combination of both age-related hearing loss and noise-induced hearing loss.
Can I prevent age-related hearing loss?
At this time, scientists don’t know how to prevent age-related hearing loss. However, you can protect yourself from noise-induced hearing loss by protecting your ears from sounds that are too loud and last too long. It’s important to be aware of potential sources of damaging noises, such as loud music, firearms, snowmobiles, lawn mowers, and leaf blowers. Avoiding loud noises, reducing the amount of time you’re exposed to loud noise, and protecting your ears with ear plugs or ear muffs are easy things you can do to protect your hearing and limit the amount of hearing you might lose as you get older.
How can I tell if I have a hearing problem?
Ask yourself the following questions. If you answer “yes” to three or more of these questions, you could have a hearing problem and may need to have your hearing checked.
- Do you sometimes feel embarrassed when you meet new people because you struggle to hear?
- Do you feel frustrated when talking to members of your family because you have difficulty hearing them?
- Do you have difficulty hearing or understanding co-workers, clients, or customers?
- Do you feel restricted or limited by a hearing problem?
- Do you have difficulty hearing when visiting friends, relatives, or neighbors?
- Do you have trouble hearing in the movies or in the theater?
- Does a hearing problem cause you to argue with family members?
- Do you have trouble hearing the TV or radio at levels that are loud enough for others?
- Do you feel that any difficulty with your hearing limits your personal or social life?
- Do you have trouble hearing family or friends when you are together in a restaurant?
Adapted from: Newman, C.W., Weinstein, B.E., Jacobson, G.P., & Hug, G.A. (1990). The Hearing Handicap Inventory for Adults [HHIA]: Psychometric adequacy and audiometric correlates. Ear Hear, 11, 430-433.